Cytomegalovirus: Symptoms, Treatments, And Types

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Medical News TodaySubscribeEverything you need to know about cytomegalovirus

Medically reviewed by University of Illinois — Written by Yvette Brazier — Updated on April 24, 2023

Symptoms
Treatment
Types
Causes
Diagnosis
Complications

Cytomegalovirus (CMV) is a herpes virus. Infection can cause flu-like symptoms, although it is often symptomless. In people with weakened immune systems, it can reactivate and affect the eyes, lungs, liver, and other organs. It can pass on to a fetus during pregnancy, which can lead to complications.

But the virus, which remains dormant in the body, can cause complications during pregnancy and for people with a weakened immune system.

The virus spreads through bodily fluids, and a pregnant person can pass it on to the unborn baby.

Also known as HCMV, CMV, or human herpesvirus 5 (HHV-5), cytomegalovirus is the most commonly transmitted virus to a developing fetus.

The Centers for Disease Control and Prevention (CDC) estimate that over 50% of adults in the United States have contracted the virus by 40 years old. It affects males and females equally, at any age and regardless of ethnicity.

Symptoms

[woman with fever] — Fever is a symptom of acquired and recurring CMV.

The symptoms will depend on the type of CMV.

Acquired CMV

Most people with acquired CMV have no noticeable symptoms, but if symptoms do occur, they may include:

fever
night sweats
tiredness and uneasiness
sore throat
swollen glands
joint and muscle pain
low appetite and weight loss

Symptoms will generally go away after 2 weeks.

Recurring CMV

Symptoms of recurring CMV vary, depending on which organs the virus has affected. Areas likely to be affected are the eyes, lungs, or digestive system.

Symptoms may include:

fever
diarrhea, gastrointestinal ulcerations, and gastrointestinal bleeding
shortness of breath
pneumonia with hypoxemia, or low blood oxygen
mouth ulcers that can be large
problems with vision, including floaters, blind spots, and blurred vision
hepatitis, or inflamed liver, with prolonged fever
encephalitis, or inflammation of the brain, leading to behavioral changes, seizures, and even coma.

A person with a weakened immune system who experiences any of these symptoms should seek medical attention.

Congenital CMV

According to the National CMV Foundation, around 90% of babies born with CMV have no symptoms, but 10–15% of them will develop hearing loss, typically during their first 6 months of life. The severity ranges from slight to total hearing loss.

In half of these children, the virus will affect just one ear, but the rest will have hearing loss in both ears. Hearing loss in both ears can lead to a higher risk of speech and communication problems later on.

If there are symptoms of congenital CMV at birth, they may include:

jaundice
pneumonia
spots under the skin
Purple skin splotches, a rash, or both
enlarged liver
enlarged spleen
low birth weight
seizures

Some of these symptoms are treatable.

CMV will impact the brain in about 75% of babies born with congenital CMV. This may lead to challenges later in life.

Conditions that they may face include:

autism
central vision loss, scarring of the retina, and uveitis, or swelling and irritation of the eye
cognitive and learning difficulties
deafness or partial hearing loss
epilepsy
impaired vision
problems with physical coordination
seizures
small head

Treatment

Scientists have been searching for a CMV vaccine, but as yet, there is no cure.

People with acquired CMV who contract the virus for the first time can use over-the-counter (OTC) pain relief medicines, such as Tylenol (acetaminophen), ibuprofen, or aspirin, to relieve symptoms and should drink plenty of fluids.

People with congenital or recurring CMV can use antiviral medications, such as ganciclovir, to slow the virus’s spread.

These medications may have adverse effects. If there is extensive organ damage, hospitalization may be necessary.

Newborns may need to stay in the hospital until their organ functions return to normal.

Prevention

The following precautions may help lower the risk of contracting CMV:

Wash the hands regularly with soap and water.
Avoid kissing a young child, including tear and saliva contact.
Avoid sharing glasses and kitchen utensils, for example, passing around a drink.
Dispose of diapers, paper handkerchiefs, and similar items carefully.
Use a condom to prevent the spread of CMV via vaginal fluids and semen.

The CDC urges parents and caregivers of children with CMV to seek treatment as early as possible, whether it is taking medication or attending all appointments for services, such as hearing checks.

Types

There are three main types of CMV infections: acquired, recurring, or congenital.

Acquired, or primary, CMV is when a person gets the virus for the first time.
Recurring CMV is when the person already has the virus. The virus is dormant and then becomes active due to a weak immune system.
Congenital CMV is when a person has the virus during pregnancy and passes it on to the fetus.

CMV is generally not a problem, except when it affects an unborn child or a person with a weak immune system, such as a recent transplant recipient or a person with HIV.

If a person with HIV contracts CMV, it can lead to organ failure, eye damage, and blindness. Improvement in antiviral medication has reduced the risk in recent years.

People who have received organ and bone marrow transplants have to take immunosuppressants to lower their immune systems so that their bodies do not reject the new organs. Dormant CMV can become active in these people and lead to organ damage.

Transplant recipients may receive antiviral medicines as a precaution against CMV.

A pregnant person can pass the virus to the fetus. This is called congenital CMV.

According to the CDC, around 1 in 200 babies are born with the virus.

Most of these infants will have no signs or symptoms, but around 20% of them will have symptoms or long-term health complications, including learning difficulties.

The symptoms may be severe, and they include vision and hearing loss, small head size, weakness, difficulty using muscles, coordination problems, and seizures.

Causes

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Cytomegalovirus is a common herpes virus that affects 50% of people by the age of 40 years.

Acquired cytomegalovirus can spread between people through bodily fluids, such as saliva, semen, blood, urine, vaginal fluids, and breast milk.

A person can also contract the virus by touching a surface that has the virus on it and then touching the inside of the nose or mouth.

Most humans contract the virus during childhood, at daycare centers, nurseries, and other places where children come into close contact with each other. However, by this age, the child’s immune system can normally deal with an infection.

Recurring CMV can occur in people with a weakened immune system due to HIV, organ transplantation, chemotherapy, or taking oral steroids for over 3 months.

Congenital CMV normally occurs when a female contracts CMV for the first time, either during pregnancy or shortly before conceiving.

Occasionally, a dormant CMV may recur during pregnancy, especially if the person has a weakened immune system.

Diagnosis

A blood test can detect the antibodies that the body creates when the immune system responds to CMV’s presence.

A pregnant person has a minimal risk that reactivation of CMV may affect her developing baby. If a doctor suspects that a pregnant person has CMV, they may suggest an amniocentesis. This involves extracting a sample of amniotic fluid to find out whether the virus is present.

If the doctor suspects congenital CMV, they will test the baby within the first 3 weeks of life. Testing later than 3 weeks will not be conclusive for congenital CMV because the baby may have contracted the virus after birth.

Anyone with a weakened immune system should have a test, even if the virus is not active. Regular monitoring for CMV complications will include testing for vision and hearing problems.

Complications

Healthy people rarely become significantly sick from CMV.

However, people with a weakened immune system may develop CMV mononucleosis, a condition in which there are too many white blood cells with a single nucleus.

Symptoms include sore throat, swollen glands, swollen tonsils, tiredness, and nausea. It can cause liver inflammation, or hepatitis, and spleen enlargement.

CMV mononucleosis is similar to classic mononucleosis caused by the Epstein-Barr Virus. (EBV). EBV mononucleosis is also known as glandular fever.

Other complications of CMV are:

gastrointestinal problems, including diarrhea, fever, abdominal pain, colon inflammation, and blood in the feces
liver function problems
central nervous system (CNS) complications, such as encephalitis, or inflammation of the brain
pneumonitis, or inflammation of lung tissue.

Immune System / Vaccines
Infectious Diseases / Bacteria / Viruses
Pediatrics / Children's Health
Pregnancy / Obstetrics

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Cytomegalovirus (CMV) and congenital CMV infection. (2020).http://www.cdc.gov/cmv/index.html
Potential outcomes of congential CMV. (n.d.). https://www.nationalcmv.org/overview/outcomes

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Medically reviewed by University of Illinois — Written by Yvette Brazier — Updated on April 24, 2023

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